The predominant way in which conventional chemotherapy kills rapidly proliferating cancer cells is the induction of DNA damage. However, chemoresistance remains the main obstacle to therapy effectivity. An increasing number of studies suggest that epithelial-to-mesenchymal transition (EMT) represents a critical process affecting the sensitivity of cancer cells to chemotherapy. Zinc finger E-box binding homeobox 1 (ZEB1) is a prime element of a network of transcription factors controlling EMT and has been identified as an important molecule in the regulation of DNA damage, cancer cell differentiation, and metastasis. Recent studies have considered upregulation of ZEB1 as a potential modulator of chemoresistance. It has been hypothesized that cancer cells undergoing EMT acquire unique properties that resemble those of cancer stem cells (CSCs). These stem-like cells manifest enhanced DNA damage response (DDR) and DNA repair capacity, self-renewal, or chemoresistance. In contrast, functional experiments have shown that ZEB1 induces chemoresistance regardless of whether other EMT-related changes occur. ZEB1 has also been identified as an important regulator of DDR by the formation of a ZEB1/p300/PCAF complex and direct interaction with ATM kinase, which has been linked to radioresistance. Moreover, ATM can directly phosphorylate ZEB1 and enhance its stability. Downregulation of ZEB1 has also been shown to reduce the abundance of CHK1, an effector kinase of DDR activated by ATR, and to induce its ubiquitin-dependent degradation. In this perspective, we focus on the role of ZEB1 in the regulation of DDR and describe the mechanisms of ZEB1-dependent chemoresistance.

Centre for BioSystems Science and Engineering Indian Institute of Science Bangalore India

Department of Clinical and Molecular Pathology Faculty of Medicine and Dentistry Institute of Molecular and Translational Medicine Palacky University Olomouc Czechia

Department of Cytokinetics Institute of Biophysics of the Czech Academy of Sciences Brno Czechia International Clinical Research Center Center for Biomolecular and Cellular Engineering St Anne's University Hospital in Brno Brno Czechia Department of Experimental Biology Faculty of Science Masaryk University Brno Czechia

International Clinical Research Center Center for Biomolecular and Cellular Engineering St Anne's University Hospital in Brno Brno Czechia Department of Urology Experimental Urology Innsbruck Medical University Innsbruck Austria

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